This application provides evidence that the University of Alabama-Zambia Team has an established record of major accomplishments in the Global Network, including leading the design, implementation, and publication of single site and common protocol studies and clinical trials. For the next 5-year cycle, three rigorously-designed multicenter randomized controlled trials are proposed. The applicant and senior foreign investigator lead a research group focused on clinical trials in Zambia and other low-resource settings. This group includes obstetrics, gynecology, neonatology, general pediatrics, public health, and infectious diseases specialists as well as midwives and research nurses who have worked together for 17 years and communicate weekly. The foreign institutional support is provided by the University Teaching Hospital, a partner during the last 17 years, which fully endorses this proposal. The available population settings where our work has been conducted include the traditional Global Network rural clusters, a large tertiary hospital delivery service, and a large set of urban delivery first level facilities. The UAB-Zambia team members are well aware of the ethical and cultural issues related to the conduct of research in Zambia and low-resource settings. The special qualifications and unequivocal commitment of the Zambian investigators, as well as the full endorsement of the Government of Zambia, University Teaching Hospital (Zambia), University of Zambia, and the University of Alabama at Birmingham will ensure superior performance if this site is granted participation in the Network. The long-term objective is to improve local health care systems with education, training, implementation, and sustainability of programs to decrease neonatal and maternal mortality, with the long-term goal of reduction of morbidities.